Pancho - ALD-ANA-66

Code: ALD-ANA-66
Mercy ID: B-00026-01
Encounter Date: 03/24/1999
Last: Aldana
First: Ana
DOB: 08/14/1966
County: Other
Street: 100 Atlanta Technology Ctr.
City: Atlanta
State: GA

Zip

30318-

Home

(000) 000-0000

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Other

Education Level

Other

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Manzo
Data Entry: K. Aleman